Medicine with Passion

Certain developments of medicine are absolutely disliked by us doctors. But wishing for something to disappear, doesn’t make it go away.

Technology and digitalization are here and they are here to stay. While in the last decades instruments of artificial intelligence mostly assisted and supported doctors, soon they’ll start to replace doctors.

Both of them don’t care, that doctors did an unbelievable job in the last decades.

Technology and digitalization don’t care that there are extremely experienced radiologists, who could discriminate bronchial carcinoma from calcification better than all of their colleagues. Very soon, Watson will take care of that. They are faster, have terabytes (meaning centuries!) of experience. Who wants to compete with that? Thanks radiologists, we don’t need you anymore.

Technology and digitalization don’t care that there are extremely gifted surgeons, who invested decades of their lifetime to learn one operation technique, which now they are the best at with the lowest complication rates. Now we’ve got the DaVinci, that sutures a grape in a freaking bottle. A bottle!! More precise results, less complication rates and they don’t sleep. And we shouldn’t fool anybody, especially not ourselves: Today, everyone is saying they don’t want to be operated on by a robot. That’ll change, once patients figure out how much better they are at operating.

My generation of physicians denies and fights the possibility that doctors will be replaced by robots.

The next generation of physicians will spend most of the time teaching robots to be, think and act like a physician.

The really exciting question is, whether after that we’ll need human physicians how we know it. I don’t have an answer. But I doubt it.

Last week I worked in the pediatric emergency room for three days. I find it extremely difficult to stay positive and motivated in an emergency room. The work in an ER is never done. There is no goal to reach. You can never close the door and say: “Sorry, we’re full.”

There is no chance to stay on top of things, people keep coming in ALL-DAY-LONG.

There is always a long line behind the check-in filled with sick people. By the time you discharge one patient, another ten patients were admitted. Ambulances keep coming in all the time. Chest pain. Shoot. Gotta check him quickly, could be AMI. ECG normal? Don’t forget ruptured aneurysm.

Four hours after the start of my shift I am hungry. Taking a break? Only with a terrible conscience. I mean, there are people who have shortness of breath, fever, a broken bone. And you are taking a break?? Are you serious? There is cake in the nurses room, take a piece and move on.

The worst part of the job: everybody is mad at you (at least that is my impression):

The nurses, because you don’t discharge or transfer fast enough. Come on, get these people out of here.

The patients because they have to wait three hours until they are seen by a doc. Then again two hours to wait for the results of X-rays and lab.

Should I explain them that in an outpatient setting they would have to wait two to three week for this kind of diagnostics? Ask them, why they didn’t go to their general practitioner with their dizziness lasting since three weeks? Tell them. No, no time. Just apologize for the long wait and move on.

I will never get used to a waiting room full of really sick and probably seriously ill patients that wait for doctors. But probably that’s what it takes to be a good ER doc.

Good triage of course is important, too. But to treat your patients well, others have to wait.

Can I finish my shift on time? Seriously? The waiting room is full, your colleague is here by himself, two ambulances just pulled in the driveway and you are leaving? What are you, kidding?

I deeply admire the doctors who work there over a longer course of time. Respect, to those guys! You are doing a tremendous job. Couldn’t trade with you.

Have you finished your goal-setting for the new year? If not, this time of the year is the perfect to set new goals, that’ll bring you ahead. Just as in any other part of your life, you should set goals for your medical career. Here is how I set goals for the new year.

5 Strategies That Never Fail.

It is easier than ever to make a great career in medicine. You wanna know why? Because your competition is very busy.

Your competition is very busy

complaining about the tough circumstances they have to work under.

because they did not organize they’re daily work schedule well and they are wasting time.

This doesn’t make it EASY for you, but it’s easier. You still need hard work and a strategy: There are five steps to follow. Apply these, and I guarantee you’ll have success.

Find out what your boss wants and overdeliver:
Every boss has different goals, opinions and priorities. On the other hand there are things he doesn’t care about at all.Make it your top goal to find out what she thinks is really important, when it comes to treating patients. Then spend time delivering on these expectations. Here are a few examples:

My first attending was all about blood gases. If I knew the patient’s CO2 by heart he was happy.

Another doc’s hot topic was the patient’s dry weight. If you didn’t know their dry weight, there was nothing you could do or say to make him happy.

Use your time wisely:
Please: don’t complain! Stop complaining right now. The toner is empty, there are too few people on your staff, and on and on we go. There are so many things going wrong. But instead of whining, use your time and energy to change the things you actually can control. Whining is for losers. Never has a chief said: That guy who is complaining all day long: I really need him on my team…hasn’t happened! Ever!

Have the patient’s best interest in mind.
This strategy will never go out of style: Listen to the patient, have his best interest at heart and everything will take care of itself. Sooner or later your patients will tell your boss what a great doctor you are and that always is a big advantage!

Hustle.
Many medical students have had it easy all their lives. I don’t want to bash the millenials all too much but basically: Their parents took care of them, but that is now over. Once you arrive in the working field, expect to work harder than ever before. Volunteer for jobs nobody else want to do. Be the first guy there and the last to leave.

Be patient. There is no overnight success. You will have to wait years until you will reap the benefits. It takes time. You have time.

Time is a precious resource. It is the most valuable resource we have, because as opposed to money and energy it can not be won back. Once it is lost, time is gone forever. So especially in the hospital I am quite intentional on how I spend my time.

And I am even more intentional about how not to spend it. Here are three things to cut out of your life to spend enormous amounts of time.

I have been working at the Charité University Medicine Berlin since 2008. Me and many of my colleagues are very content with working here, but every now and then you hear cynical voices about how bad, slow and misorganized things supposedly are.

As I have written before, I think that this discontent should always trigger some kind of constructive action. You always have a choice:

change things to the better or ultimately, if you just can’t stand it anymore:

you can look for another organization that may fit your needs better.

However, how do you protect yourself from cynicism and depression when people around you are whining?

Gratitude is always a great move. I like to point out the good things of life. For that matter I created a list of things I like or even love about working here. Here is my Top-15-List of things I like about the Charité:

I am trained here by amazing physicians.

They pay me money. Fair and on time.

Fast internet at every workstation and coming up:

Reliable WiFi on most wards.

Uncountable numbers of experts for every topic: I call them and they will help me and the patient.

Every day I come across several problems that I am not responsible for:

Personal computer in the doctor’s room is slow.

Printer is out of toner.

Biopsy gun is broken.

Two out of three elevators don’t seem to work.

The only closet in the physician’s office is filled with old patient files.

All of these common problems not only cause delay in our workflow but lead to great frustration in your team. By choosing your reaction to all of these issues you make a great decision between ongoing frustration and improving the quality of your work.